Digestive Diseases and Sciences

, Volume 53, Issue 3, pp 760–764

Squamous Dysplasia of the Rectum in a Patient with Ulcerative Colitis Treated with 6-Mercaptopurine

  • Rachel Greenberg
  • Bruce Greenwald
  • J. Scott Roth
  • Olga Ioffe
  • Raymond Cross
Original Paper

DOI: 10.1007/s10620-007-9935-9

Cite this article as:
Greenberg, R., Greenwald, B., Roth, J.S. et al. Dig Dis Sci (2008) 53: 760. doi:10.1007/s10620-007-9935-9

Abstract

Human papilloma virus (HPV) has been found to be a precursor and risk factor for both cervical and anal dysplasia. Cervical dysplasia, which is the precursor to carcinoma, is associated with immunosuppression from a variety of causes; reports of anal dysplasia associated with immune suppression exist as well. A recent study published in abstract form only demonstrated that women with inflammatory bowel disease (IBD) had high rates of cervical dysplasia and that those on immune suppressants had even higher rates of dysplasia. We report a case of a 50-year-old woman with refractory ulcerative colitis chronically treated with 6-mercaptopurine that developed severe squamous dysplasia of the rectum. The dysplastic mucosa was found to be positive for p16 (associated with high-risk HPV) after immunostaining. A total colectomy was performed. This case highlights the importance of immune suppression in the development of dysplasia of the anus/cervix secondary to HPV infection.

Keywords

Inflammatory bowel diseaseUlcerative colitisHuman papilloma virusImmune suppressantsAnal cancer

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Rachel Greenberg
    • 1
  • Bruce Greenwald
    • 2
  • J. Scott Roth
    • 3
  • Olga Ioffe
    • 4
  • Raymond Cross
    • 2
    • 5
  1. 1.Department of MedicineUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Department of Medicine, Division of Gastroenterology and HepatologyUniversity of Maryland School of MedicineBaltimoreUSA
  3. 3.Department of Surgery, Division of General SurgeryUniversity of Maryland School of MedicineBaltimoreUSA
  4. 4.Department of PathologyUniversity of Maryland School of MedicineBaltimoreUSA
  5. 5.Veterans AffairsMaryland Heath Care SystemBaltimoreUSA